脊柱与普通麻醉对老年人手术的比较有效性研究
Mark D Neuman1, Frederick Sieber2, Derek Dillane3
1Mark D. Neuman, M.D., MSc.; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
对于老年人来说,脊柱和全身麻醉在重大手术中显示出类似的安全性和有效性. 患者的偏好应该指导麻醉选择,当证据显示同等性.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 相对有效性研究研究比较
背景情况:
- 对比疗效研究 (CER) 对于明智的医疗决策至关重要.
- 老年人的麻醉选择 (脊柱与一般) 是一个关键的CER领域.
- 接受手术的老年人需要仔细考虑麻醉的风险和益处.
研究的目的:
- 审查在比较脊椎和全身麻醉的方法挑战.
- 总结关于脊柱与普通麻醉在老年人中比较有效性的证据.
- 为了为临床决策提供有关老年患者麻醉选择的信息.
主要方法:
- 随机对照试验的系统审查.
- 分析关节骨折手术,关节/膝关节整形手术和血管手术的证据.
- 对安全性和可接受性结果的评估.
主要成果:
- 随机试验表明,脊柱和全身麻醉对于大多数老年人来说通常是相当的,没有任何禁忌.
- 在这两种麻醉类型之间,没有发现安全性或可接受性的显著差异.
- 有证据表明,在各种外科手术环境中存在相当性.
结论:
- 对于老年人来说,脊椎和全身麻醉之间的选择是偏好敏感的.
- 患者的价值观和偏好,以及证据,应该指导麻醉决定.
- 在老年人群中,共享决策对于最佳的术后护理至关重要.
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